HomeMy WebLinkAbout25-80067 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG55427oc� RA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-80067 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LdCAI-A`NG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E IN cDLLISION' 11 - 22 - 2025 1418 17 =.= S 8 W e OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 2ND ST BLOCK NO. e 200 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 25 00 FEET e✓ S 8 W e LAKE AVE S
2 0 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2533586585 0 1 30
5❑ LAST NAME OSTERAA FIRST NAME TORT MIDDLE K 1 2 31
INITIAL
STREET ❑ 320 N J ST CITY; TACOMA ST I WA ZIP; 98403 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYEs NO YES NOFJ
8❑ DRIVER # STATE WA SEXI F MMDDYY' 08 — 07 — 1993 1 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 3 EJECT 1 N USEET INJUR
CLASSY 14 1
NATURE of INJURIES 2
LICENSE, CJS1980 STATE WA VIN# ZACCJBBBOJPH46965 3
10 Fq I as ATP rt
TRAILER
11 0 0 STATE TRAILER STATE ROM To
PLATE# PLATE#
TRLR TRLR. 3 1 7 33
12 O O VIN#' vIN#
FROM TO
VEH.YEAR 2018 MAKE JEEP MODEL RENEG STYLE VT VEHICLE TOWED[n TO ZBLIN TOWED BY GOVT VEHICLE 3 7 34
13 DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 4
14❑ LIABILITY INSURANCE NSURANCECO USAA CASUALTY 01223 67 62C
IN EFFECT &POLICY# 4TOP _
VEHICLE CHARGE 5 36
15
srIALLY YES[:]❑NO❑ CITATION# IMPROPER LANE USAGE o oorrofi
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES�/ NO D:2064093262
16�
LAST NAME CHEA FIRST NAME KEA-AN MIDDLE P
INITIAL
STREET ❑
17 ❑ 9264 52ND AVE S CITY SEATTLE ST, WA ZIP 98118 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPC7RTE0' ❑ 38
INTERLOCK YEs NO INTERLOOKYEs NO YES NO
19 DRIVERS STATE WA SEX M D.O.B. 01 01 1959 � 39
'..LICENSE# MMD6YY' —
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICEN E LATEIC47233S rare WA vIN# 5TBBT4813YS057573 41
22❑ PLATE# STATE[TILER I PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2000 MAKE TOYT MODEL TUNDRA STYLE pl( VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO NO
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE
NQ.2
SHADFY DAGEAREA
LIABILITY INSURANCE INSURANCECO ALLSTATE 817 966 460
IN EFFECT &POLICY# 9TOP
L'EIL ❑ CO CITATION# CHARGE t080TTOM
VEHICLE YES NCO
s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
SITIVENI TAMAIVENA 12812 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG55427
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80067
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE GLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE 0,SS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I USE CLASS
NARRATIVE
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
SITIVENI TAMAIVENA 11-23-25 05:41 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 121512025 5:40:56 AM
BADGE OR ID# 12812 ORI# WA0171300 TIME POLICE DISPATCHED 1 2:34 PM TIME POLICE ARRIVED i 2:37 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG55427 CASE# 25-80067 O OF COLLI 510N TIME 11/22/25 14:18
COLLISION
NARRATIVE
During this incident, I was equipped with a body-worn camera. It is important to note that the camera
may have captured things I did not perceive, and I may have perceived things not captured by the
camera. This report is intended as a summary of events to the best of my recollection and perception
of what occurred. I have paraphrased conversation(s) and may not include an exact sequencing of
events. Any inaccuracies, omissions, or mistakes are inadvertent.
25-80067
On 11-22-2025, at 1418 hours, I was dispatched to a blocking accident located at S 2nd St and Lake
Ave S, within the City of Renton, King County, State of Washington.
The Driver of Unit 2 is CHEA, KEA-AN PHATT (DOB 01-01-1959). KEA-AN was the driver/registered
of a 2000 Toyota Tundra bearing plate WA/C47233S. KEA-AN had a passenger who did not want to
be identified.
The Driver of Unit 1 is OSTERAA, TORI KRISTIN (DOB 08-07-1993). TORI was the driver/registered
of a 2018 Jeep Renegade bearing plate WA/CJS1980. TORT was the only occupant of the Jeep.
There was no witness.
KEA-AN stated he was in lane 1 going westbound on S 2nd St. While going straight ahead, he stated
that TORI was in lane two trying to make a left turn into the Safeway property. He stated that sudden
left turn caused him to collide with her Jeep.
TORT stated she was on S 2nd St going westbound in lane 2. She said that she had her signal on to
merge into lane 1 so she could make a left turn into the Safeway parking lot. This is when TORI
struck the Toyota. She stated that the Toyota did not stop during the collision but continued to move
forward, extending the damage from the front to the rear of the passenger side.
There were no claims of injuries for this incident.
Damages: TORI had minor damage to the front bumper of her Jeep. TORI Jeep was still drivable.
KEA-AN sustained minor damage from the front passenger side to the rear of the Toyota. The Toyota
was still drivable.
I believe the approximate cause of this collision was TORI. TORT did not safely change lanes.
TORI was cited for (RCW 46.61.140) (1) A vehicle shall be driven as nearly as practicable entirely
within a single lane and shall not be moved from such lane until the driver has first ascertained that
such movement can be made with safety.
(2) Upon a roadway which is divided into three lanes and provides for two-way movement of traffic, a
vehicle shall not be driven in the center lane except when overtaking and passing another vehicle
traveling in the same direction when such center lane is clear of traffic within a safe distance, or in
preparation for making a left turn or where such center lane is at the time allocated exclusively to
traffic moving in the same direction that the vehicle is proceeding and such allocation is designated
by official traffic-control devices. I advised TORI that she will be receiving a citation through email,
which she understood.
My Axon camera was on for this call.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer Si. Tamaivena #12812,
November 22, 2025, at 1657 Renton, WA.
PAGE 3 OF 4
REPORT NO. EG55427 CASE# 25-80067 DATE AND TIME 11/22/2514:18
OF COLLISION
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